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Preserving Do No Harm: Supreme Court Tosses Challenge to Medical Ethics Committee Law. - 02/18/2020

Twenty years after it took effect, Texas’ medical ethics committee review law has withstood challenge after challenge. The Texas Supreme Court is on the verge of ending the latest high-profile attack on the law that ensures physicians can uphold their professional obligation to “do no harm.” In October 2019, the state’s high court declined to take up Kelly v. Houston Methodist Hospital, in which the mother of a deceased patient attempted to overturn a provision of the Texas Advance Directives Act. Justices’ action leaves intact an appeals court decision that preserves physicians’ ability to use their medical judgment in end-of-life cases.


Finally Settled: Hospitals Settle Physician's Anti-Competition Lawsuit - 01/08/2020

A Laredo oncologist confidentially settled a years-long lawsuit involving a pair of hospitals he alleged mischaracterized a past legal misfortune to terminate his privileges and eliminate his clinic from competing with the facilities.


An Injury to Justice: Workers' Comp Disputes Could Tilt in Insurers' Favor - 01/02/2020

Medicine is working to upend a recent appeals court decision that threatens to give health plans an overwhelming advantage in fee disputes in workers compensation cases.


Easing the Pain? Opioid Settlement Brings Valuable Funding to Fight Crisis - 11/01/2019

September 2019 brought what could become a major victory for the state’s handling of opioid addiction. Drug-maker Purdue Pharma – which faced thousands of lawsuits from cities and states, including Texas, for its role in the national opioid crisis – announced it had agreed to a settlement with 24 state attorneys general and other plaintiffs. The maker of OxyContin and other pain drugs says the agreement will provide more than $10 billion to address the epidemic.


No Docs of All Trades: Ruling Reinforces Expert Witness Reforms - 09/26/2019

Before Texas’ landmark liability reforms passed in 2003, gray areas in the law often led to serious green for people who sued physicians.


Fighting Back: Practice Wins Court Battle Over Defamatory Online Reviews - 09/03/2019

One practice’s recent legal battle epitomizes physicians’ worst nightmares when it comes to online reviews. Here’s an extreme but glaring real world example, straight from the documents in a lawsuit that Austin Eye first filed in October 2017 over


Medical Futility Law Sustained - 08/02/2019

Court tosses out challenge to ethics committee review of end-of-life care.


Final Verdict? Case Tests Court's Ability to Overturn a Jury Verdict - 08/02/2019

It was an overwhelming, 12-0 verdict – a jury’s unanimous rejection of a negligence case against a Laredo physician. Then, a judge took that decision away and ordered a new trial – not because of jury misconduct, or any procedural stumble that usually negates a court decision. It was taken away, essentially, because the judge said so.


The Meaning of Monthly: Court Ruling Offers Hope on Pain Clinic Registrations - 08/02/2019

Physicians can encounter a web of confusion and unfairness when it comes to navigating the Texas Medical Board (TMB). A Travis County district court has given Texas physicians clarity and hope when it comes to certain medical board investigations. The court’s decision, if it holds up, establishes an important precedent for when physicians are required to register their facility as a pain management clinic.


Setting the Record Straight: Supreme Court Curtails TMB for Over-Sanctioning Physician - 08/02/2019

Eight years ago, when he experienced a rare patient death, McAllen family physician Ruben Aleman, MD, signed the death certificate the way Texas physicians had been doing it for years, and the only way he knew how: using pen and paper. That resulted in the Texas Medical Board (TMB) not only coming after him, but accusing him of “unprofessional or dishonorable conduct that is likely to deceive or defraud the public” – words found in the state Medical Practice Act. The Texas Supreme Court recently decided that was an overreach for a physician who simply hadn’t signed up on the state’s electronic death registration system, which at the time was relatively new.


Dos and Don’ts of Using Modifier 22 - 04/25/2019

Sometimes the work to provide a service is “substantially greater” than typically required on the date of services. When this happens, document the extra work by adding modifier 22 to the procedure code.


Charging Concierge Fees to BCBSTX Patients - 04/23/2019

Although Blue Cross and Blue Shield of Texas (BCBSTX) places limits on the additional fees participating network physicians can charge BCBSTX patients, some are allowed when you provide concierge services.


Breaking Up Is Hard to Do: Physicians Can Get Subpoenaed in Divorce Cases - 03/11/2019

Physicians subpoenaed to participate in a divorce case, whether to testify or simply to supply medical records to the court, could find themselves at the center of an acrimonious split. There are certain things they should know.


The Right to Fight: Attorney-Client Protections for Physicians and Other Professionals Under Threat - 03/05/2019

The Texas Medical Association is asking the Texas Supreme Court to make sure physicians can maintain the right to keep attorney-client communications private when doctors testify as experts in their own cases.


Expect HEDIS Records Requests From Third Parties - 02/28/2019

If a company called Ciox Health contacts your office on behalf of Blue Cross and Blue Shield of Texas or UnitedHealthcare, it is because both insurers have contracted with Ciox to collect performance data they are required by law to report.


The Risk of Speaking Up - 02/04/2019

Whistleblowing may be ethical, but physician protections for it could stand to improve.


“A Threat to All Texas Physicians:” TMA Backs Surgeon in Defamation Suit - 01/02/2019

Miguel Gomez, MD’s well-publicized legal fight isn’t over yet. In its latest turn, the Texas Medical Association is still standing behind the surgeon as he fights to uphold a verdict against one of the state’s largest nonprofit hospital systems for defaming him.


Court Sides With Medical Examiner in Suit Over Autopsy - 12/21/2018

With the Texas Medical Association’s help, a Harris County medical examiner has won the latest battle in a lawsuit over an autopsy he performed following a woman’s 2007 shooting death.


Legal Examination: Case Tests Lawsuit Immunity For Medical Examiners - 12/21/2018

Case tests lawsuit immunity for medical examiners.


Don’t Fall for Credentialing Scam, Blue Cross Says - 10/23/2018

Blue Cross and Blue Shield of Texas warns physicians to be aware of a scammer that is offering to help doctors become credentialed with the insurance company for $250.


Blue Cross HMO Emergency Payment Review Policy Begins - 08/10/2018

Beginning today, Blue Cross Blue and Shield of Texas will require some members to pay 100 percent of their medical bills if they go to an out-of-network emergency room for certain non-life-threatening conditions, company officials have confirmed.


From Blue Cross: What to Fax, Where to Find Answers - 08/07/2018

Here is a heads up on a couple of changes in Blue Cross and Blue Shield of Texas’ preauthorization and predetermination processes.


Office Cleaners Clean Up on Patient Files - 07/10/2018

Two Austin men now face federal prison sentences after pleading guilty to conspiracy to commit fraud, and two others are still wanted as part of an identity theft ring, according to a recent statement from the U.S. Attorney’s Office for the Western District of Texas. Their targets: patient files lifted when they worked for an office cleaning company that serviced medical practices.


Blue Cross to Put Off HMO Emergency Coverage Policy Until August - 06/27/2018

Blue Cross and Blue Shield of Texas will delay for 60 days a new HMO emergency care policy it had originally planned to begin on Monday, June 4.


Submitting Med Records, and More Tips From Blue Cross - 06/26/2018

Here’s some news you can use from Blue Cross and Blue Shield of Texas.